Cross Lineage Rearrangement in Feline Enteropathy-Associated T-cell Lymphoma

Feline enteropathy-associated T-cell lymphoma (EATL) type II is characterized by infiltration of the small intestinal mucosa with small T-cells with variable epitheliotropism and is often difficult to differentiate from inflammation. Polymerase chain reaction (PCR) to assess antigen receptor rearrangements (PARR) amplifies the T- (T-cell receptor gamma, TCRG) or B-cell (immunoglobulin heavy chain, IGH) antigen receptor genes and is used to differentiate EATL from inflammation. However, PARR does not determine lymphocyte phenotype, and clonal rearrangement of either or both the TCRG or IGH genes may be detected in neoplastic T-cells. The purpose of this study was to determine the incidence of cross lineage rearrangement in feline EATL type II. Using a diagnostic algorithm combining histology, immunohistochemistry, and PARR testing, 8 of 92 cases diagnosed as EATL type II at Michigan State University between January 2013 and June 2014 showed cross lineage rearrangement (8.7%). PARR for the IGH gene facilitates the diagnosis of cases histologically highly suggestive of EATL type II in which polyclonal rearrangement of the TCRG gene is detected.

Experimental evidence of reaction-driven miscible viscous fingering

An experimental demonstration of reaction-driven viscous fingering developing when a more viscous solution of a reactant A displaces a less viscous miscible solution of another reactant B is presented. In the absence of reaction, such a displacement of one fluid by another less mobile one is classically stable. However, a simple A+B→C reaction can destabilize this interface if the product C is either more or less viscous than both reactant solutions. Using the pH dependence of the viscosity of some polymer solutions, we provide experimental evidence of both scenarios. We demonstrate quantitatively that reactive viscous fingering results from the buildup in time of nonmonotonic viscosity profiles with patterns behind or ahead of the reaction zone, depending on whether the product is more or less viscous than the reactants. The experimental findings are backed up by numerical simulations.

Salivary potential

There is renewed interest in saliva as a “non-invasive” specimen for therapeutic drug monitoring, diagnosis and doping control

Meningoencephalitis in a Polar Bear Caused by Equine Herpesvirus 9 (EHV-9)

A 12-year-old female polar bear ( Ursus maritimus) developed a sudden onset of muscle tremors, erratic circling, increased blinking, head shaking, and ptyalism, which progressed to partial and generalized seizures. Ancillary diagnostic tests were inconclusive, and the only significant laboratory finding was nonsuppurative pleocytosis of cerebrospinal fluid. Euthanasia was elected. Microscopic evaluation demonstrated multifocal, random nonsuppurative meningoencephalitis involving most prominently the rostral cerebral cortex, as well as the thalamus, midbrain, and rostral medulla. Lesions consisted of inflammation, neuronal necrosis, gliosis, and both neuronal and glial basophilic intranuclear inclusion bodies. Immunohistochemistry with a polyclonal antibody reactive to several equine herpesviruses was positive within affected areas of the brain, and polymerase chain reaction conclusively demonstrated the presence of only equine herpesvirus 9. The clinical and morphologic features of this case resemble other fatal herpesvirus encephalitides derived from interspecies transmission and underscore the need for extreme caution when managing wild or captive equids.

Equine multinodular pulmonary fibrosis: a newly recognized herpesvirus-associated fibrotic lung disease

Pulmonary fibrosis and interstitial lung disease are poorly understood in horses; the causes of such conditions are rarely identified. Equine herpesvirus 5 (EHV-5) is a gamma-herpesvirus of horses that has not been associated with disease in horses. Pathologic and virologic findings from 24 horses with progressive nodular fibrotic lung disease associated with EHV-5 infection are described and compared with 23 age-matched control animals. Gross lesions consisted of multiple nodules of fibrosis throughout the lungs. Histologically, there was marked interstitial fibrosis, often with preservation of an "alveolar-like" architecture, lined by cuboidal epithelial cells. The airways contained primarily neutrophils and macrophages. Rare macrophages contained large eosinophilic intranuclear viral inclusion bodies; similar inclusion bodies were also found cytologically. The inclusions were identified as herpesviral-like particles by transmission electron microscopy in a single horse. In situ hybridization was used to detect EHV-5 nucleic acids within occasional macrophage nuclei. With polymerase chain reaction (PCR), the herpesviral DNA polymerase gene was detected in 19/24 (79.2%) of affected horses and 2/23 (8.7%) of the control horses. Virus genera-specific PCR was used to detect EHV-5 in all of the affected horses and none of the control horses. EHV-2 was detected in 8/24 (33.3%) of affected horses and 1/9 (11.1%) of the control horses. This disease has not been reported before, and the authors propose that based upon the characteristic gross and histologic findings, the disease be known as equine multinodular pulmonary fibrosis. Further, we propose that this newly described disease develops in association with infection by the equine gamma-herpesvirus, EHV-5.

[Electronical podometry: EMD system]

The loads supported by the feet can be appreciated by the analysis of footprints. X-rays of the feet in weight-bearing complete the static analysis of the foot. The footprints and X-rays of the feet allow to obtain a static assessment of the loads applied on the foot. With the evolution of the technology, the EMED system for measuring dynamic foot pressures is appeared. The EMED system with the different clinical applications is described.

[Study of the plantar arch: correlations between podometrical and radiological parameters. results of a prospective study of 79 cases]

The authors present a prospective study on the potential correlations between eight footprint parameters and three radiological parameters in the study of the plantar arch. Seventy nine patients were evaluated in 2001. The eight footprint parameters were as fellows : the arch angle, the Chippaux-Smirak's index, the Quamra's contact index 2,3 and 4, the Schwartz's footprint angle, the Staheli's arch index and the arch length index. The three radiological parameters were as fellows : the Djian-Annonier's angle, the Méary's angle and the calcaneal inclination. This prospective study confirms the best correlation, found in others studies, obtained between the Djian-Annonier's angle and the Chippaux-Smirak. The use of the Méary's angle and the calcaneal inclination is not justified because they have bad correlations with footprint parameters.

Peliod hepatocellular carcinoma in a domesticated ferret (Mustela putorius furo)

Peliod hepatocellular carcinoma was diagnosed in a domesticated ferret (Mustela putorius furo). The diagnosis was made using immunohistochemical analysis, histologic examination, and the accepted classification schemes based on histomorphologic features. Bilateral, adrenocortical hyperplasia also was evident. Speculation about a possible association between the variant of hepatocellular neoplasia diagnosed in this animal and its adrenal pathologic changes was done.

Meningoencephalomyelitis caused by Neospora caninum in a juvenile fallow deer (Dama dama)

Neosporosis, caused by the protozoan parasite Neospora caninum, is a serious cause of bovine abortion, stillbirth and perinatal death. This paper reports a clinical neosporosis in a 3-week-old fallow deer (Dama dama). The fawn was full term and appeared normal at birth. Histological lesions consisted of a multifocal necrotizing and granulomatous meningoencephalomyelitis, with intralesional protozoal cysts. Positive immunohistochemical staining and characteristic PCR products confirmed the diagnosis of N. caninum infection.

Les ruptures du tendon bicipital distal et leur traitement chirurgical

PURPOSE OF THE STUDY

Avulsion of the distal biceps brachii tendon at the elbow is uncommon. We analyzed cases operated in our department in order to define etiological factors and surgical treatment outcome.

MATERIAL AND METHODS

We reviewed retrospectively eleven patients, ten male patients, average age 43 years (range 37-59) with distal biceps tendon ruptures repaired anatomically with a double-incision technique and one other male patient whose tendon was attached to the brachialis anterior. Nine patients were seen for clinical assessment at least two years after operation.

RESULTS

Average follow-up was 7 years (range 1-10). Patient satisfaction was good and all stated they would opt for surgical treatment again. The most common mechanism of injury was heavy weight lifting with the elbow at 90 degrees flexion or excentric loading on a flexed elbow. The dominant limb was injured in all patients. Eight patients had sustained injury during domestic activities and three during sports activities. Clinical diagnosis was the rule. MRI was useful in patients seen late after injury. We found nine cases of avulsion located at the bicipital tuberosity. All subjective results were good. Strength testing of the injured limbs revealed a loss of 30% supination strength and 40% supination endurance for the anatomic reinsertions. For the non-anatomic reinsertion, there was a 50% decrease in strength and 60% decrease in endurance. Clinical follow-up after seven years showed no nerve damage or heterotopic bone formation.

DISCUSSION

Anatomic repair of distal biceps tendon rupture provides consistently good results. Attachment of the brachial tendon to the brachial anterior muscle cannot restore supination force. The two-incision technique with the extensor mass-splitting approach described by Boyd and Anderson lessens the risk of radial nerve plasty.

CONCLUSION

Early anatomic reconstruction can restore more strength and endurance for supination. Attachment of the brachialis muscle must be considered in the event of late reconstruction. Subjective satisfaction with functional outcome has been excellent for all patients.

West Nile virus infection in Eastern fox squirrels (Sciurus niger)

Since the initial outbreak of West Nile virus (WNV) in the northeastern United States in 1999, the virus has rapidly spread westward and southward across the USA, causing high mortality in crows as well as sporadic mortality in horses, humans, and a wide variety of birds. In 2002 the epidemic widened as hundreds of equine and human cases and sporadic cases in other mammalian species were reported. This is the first report of WNV infection in three Eastern fox squirrels (Sciurus niger). Neurologic signs included head tilt, uncoordinated movement, paralysis, and tremors. Gross lesions were absent. Microscopic lesions consisted of lymphoplasmacytic inflammation involving the brain, heart, kidney, and liver. Formalin-fixed tissues from the three squirrels were tested for WNV antigen by immunohistochemical staining and for WNV-specific RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). The kidneys of all three squirrels stained positive with immunohistochemistry for WNV, whereas the brain and heart were positive in only one animal. Two of the three squirrels were positive for WNV by RT-PCR.

[Lateral peritalar luxation: prognostic evaluation and therapeutic approach. Review of the literature based on a clinical case]

The incidence of the peritalar dislocations has been estimated to be approximately 1% of all dislocations. If they are missed, the consequences are serious and lead to an important surgery of the hindfoot. Lateral dislocation is most rare than medial dislocation. The diagnosis of this lesion often requires X-rays of the foot. The CT-scan allows to confirm the diagnosis and to appreciate the associated intra-articular fracture. The reduction must be realized in urgency under anaesthesia. If the orthopaedic reduction is impossible, the surgery allows to obtain an anatomical reduction with the removal of obstacles and the fixation of the associated intra-articular fractures. The prognosis of this lesion is better if there is an appropriate and rapid treatment.

Cloning of two cDNAs encoding isoforms of a pacifastin-related precursor polypeptide in the desert locust, Schistocerca gregaria: analysis of stage- and tissue-dependent expression

A novel serine protease inhibitor peptide family, designated as the 'pacifastin family', has recently been described in insects (locusts, lepidopterans) and crustaceans (crayfish). This study presents the cDNA cloning of two isoforms of SGPP-3, a novel pacifastin-related precursor in the desert locust, Schistocerca gregaria, which codes for three putative inhibitor peptides. The precursor isoforms differ at a single amino acid position in the third, C-terminal peptide. Northern blot analysis confirmed the presence of two different transcripts (0.75 and 0.90 kb). Both transcripts are most abundant in the fat body and appear to be strongly regulated during the moulting cycle. In addition, the amount of transcript proved to be strictly regulated in the ovaries during the female reproductive cycle.

[Increasing incidence of knee ligament injuries in alpine skiing: epidemiology and etiopathogenetic hypotheses]

20 to 25% of all the injuries are due to traumas of the knee since forty years. The amount of serious sprains has been in constant increasing during the last four decades. The ratio of one to two in 1960 between and ankle injuries was of six to one in 1987. The inversion of this ratio is probably due to the evolution of technics from 1960 forth, to plastic shoes with thicker soles, to the wrong adjustment of binding and to the higher speed of the skiers thanks to better mending of tracks. The frequency of injury of ligamental structures is higher for the internal lateral ligament and for the anterior cruciate ligament. A valgus associated to internal leg rotation in consequence of blocking of internal edge and of forward falling causes internal lateral ligament injury. The three lesional mechanisms of the anterior cruciate ligament are the valgus connected with external rotation, the anterior draw caused by the shoe in case of backward falling and the association valgus-flexion-internal rotation ("foot-phantom"). These lesions of ligaments are often connected with lesions of the external meniscus and with osseous contusions concerning the external femoral condyle and the external tibial plate.

Nanotechnology in bio/clinical analysis

Nanotechnology is being exploited now in different fields of analytical chemistry: Single cell analysis; in chip/micro machined devices; hyphenated technology and sampling techniques. Secretory vesicles can be chemically and individually analyzed with a combination of optical trapping, capillary electrophoresis separation, and laser induced fluorescence detection. Attoliters (10(-18) l) can be introduced into the tapered inlets of separation capillaries. Chip technology has come of age in the field of genomics, allowing faster analyses, and will fulfil an important role in RNA and peptide/protein analysis. The introduction of nanotechnology in LC-MS and CE-MS has resulted in new findings in the study of DNA adduct formation caused by carcinogenic substances, including anticancer drugs. Sample handling and introduction also can benefit from nanotechnology: The downscaling of sample volumes to the picoliter level has resulted in zeptomole (10(-21)) detection limits in the single-shot mass spectrum of proteins.

Factors determining the place of palliative care and death of cancer patients

Factors determining the place of palliative care and death were studied by interviewing 40 patients using a semi-structured questionnaire. The 86 interviews assessed showed that both emotional and somatic factors played a part in the determination of whether patients were transferred and of their place of death. Emotional factors were mentioned in 41% as being of importance, and physical factors in 32%. Material and financial factors are probably underestimated owing to the methodology.

General practitioners caring for terminally ill patients resident in a hospice

The goal of this study was to investigate why GPs have little or no involvement in the medical process relating to any of their patients when they are admitted to a palliative care unit (PCU) and what solutions they suggest. The study took the form of a descriptive pilot study based on a short questionnaire. It emerged that GPs felt their involvement was influenced by their job description, by practical factors (time investment, distance between practice and PCU, remuneration, referral) and personal issues (e.g. dealing with dying). It is concluded that GPs need education in palliative/supportive care and approved remuneration as well as knowledge about their task in the PCU.

P-glycoprotein: clinical significance and methods of analysis

Multidrug resistance (MDR) is responsible for a decrease in sensitivity of tumor cells tumor cells to unrelated, naturally occurring anticancer drugs. This resistance is correlated with expression and activity of a membrane protein, P-gp 170, functioning as a drug-extruding pump. It has been well described in in vitro situations; however, the clinical detection and implications are not yet clear. Multiple detection assays have been developed based on the discovery of the MDR gene family and the corresponding protein. Southern, Northern, or Western blot analysis, S1 nuclease protection or PCR-based assays, immunohistochemical detection or functionality tests by flow cytometry have been used extensively. However, by use of these techniques on clinical material, both normal and malignant, contradictory results have emerged. The sensitivity and specificity of a certain technique are always limited by unavoidable parameters, for example, skill of the technician. Moreover, the complexity of the development of resistance against anticancer agents (external determinants), such as the diversity of tumor tissues, the simultaneous presence of other resistance mechanisms, and the low expression level, make MDR detection equivocal and can lead to contradictory results. Previous treatment influencing the MDR profile and inappropriate timing of the test make a possible correlation between MDR expression and chemotherapeutic resistance difficult to establish and can lead to discordant results. In this review, the need for proper criteria is stressed. No single detection technique provides the ideal test to detect MDR. Tandem testing could give more certainty, although small sample size limit this application. Formulation of a standard assay with better definition of a positivity is essential before clinical trials are started.

Prospective randomized study on the cryopreservation of human embryos with dimethylsulfoxide or 1,2-propanediol protocols

OBJECTIVE

To investigate the optimal protocol for cryopreservation of human embryos obtained from IVF.

DESIGN

Prospective randomized study.

SETTING

Consenting patients in an academic research environment.

PATIENTS

Couples undergoing IVF.

INTERVENTIONS

A cohort of 2,220 supernumerary multicellular embryos were obtained from 488 patients who were randomized over slow freezing protocols with dimethylsulfoxide (DMSO, 819 embryos), 1,2-propanediol (699 embryos) or a mixture of DMSO and 1,2-propanediol (702 embryos). A total of 725 embryos have been thawed (DMSO, 232 embryos; 1,2-propanediol, 250 embryos and DMSO and 1,2-propanediol, 243 embryos) for transfer in natural ovarian cycles.

MAIN OUTCOME MEASURES

Embryo survival rate, embryo implantation rate, clinical pregnancy rate (PR), delivery rate, live-birth rate.

RESULTS

The embryo survival rate was significantly higher with the DMSO protocol (52.6%) than with the 1,2-propanediol (32.0%) or the DMSO and 1,2-propanediol protocols (34.9%). The clinical PR per thawing cycle was significantly higher in the DMSO protocol (17.2%) than in the 1,2-propanediol protocol (3.9%). The clinical implantation rate per embryo thawed was significantly different between a DMSO-frozen embryo (4.7%) and a 1,2-propanediol-frozen embryo (1.2%). A DMSO and 1,2-propanediol-frozen embryo had a 3.7% chance of of implantation. The delivery rate per thawing cycle was significantly higher in the DMSO protocol (12.5%) than in the 1,2-propanediol protocol (2.6%). The live-birth rates per embryo thawed were 3.5%, 0.8%, and 2.9% in the DMSO, 1,2-propanediol, and DMSO and 1,2-propanediol groups, respectively.

CONCLUSION

Supernumerary multicellular embryos as presented in daily clinical IVF practice have the highest chance of survival and of implantation after cryopreservation when DMSO has been used.

Clinical usefulness of serological measurements obtained by antigen 60 in mycobacterial infections: development of a new concept

The humoral immune response occurring during mycobacterial infections was analysed with an ELISA test based on antigen 60. With tuberculosis, IgM antibodies indicate a primo-infection or a process of reactivation while IgG determinations allow an evaluation of the intensity of the infectious process. The test is also applicable to extrapulmonary tuberculosis, provided its sensitivity be adapted to these particular cases. This is particularly clear for tuberculous meningitis. The test is not species-specific and allows the detection of antibodies in atypical mycobacterioses and in leprosy patients. The final differentiation must be done by clinical examinations and cultures. In leprosy patients, IgM antibodies are detected nearly as frequently as IgG antibodies. In HIV-seropositive patients, the A60 seropositivity is correlated with a reactivation of former tuberculous infections and with primary tuberculous infections. At the AIDS stage, the A-60 seropositivity is due to atypical mycobacteria, with a better IgM than IgG response. Healthy people are negative in serology: the positive cases observed are due to inapparent infections gained by contact with an infectious focus. The seropositive cases observed in non-tuberculous hospitalized patients are restricted to some disease types, essentially lung infections (cystic fibrosis, cancer pneumopathies, sarcoidosis). Some patients have low levels of antibodies. This anergy may be traced to the formation of immune complexes or else to a weak avidity of the specific antibodies produced. This test should not be considered to be a diagnostic tool by itself. It should be used in conjunction with other diagnostic means that, together, allow the determination of a diagnosis.

ELISA serodiagnosis of Johne's disease in cattle

An ELISA test for the serodiagnosis of M. paratuberculosis in cattle has been developed. The test is based on antigen 60 from BCG. It is specific for myocobacteria and detects M. bovis and M. paratuberculosis antibodies. The correlation between sero-units and complement fixation is not an absolute one. On the basis of these preliminary results, a cut-off established at an optical density (OD) of 0.42-0.45 when the sera are analysed at a 1:100 dilution, corresponding to 200 serounits, seems to be adequate. The greatest usefulness of the test appears to consist in the exclusion of a presumed mycobacterial infection.

Development of an enzyme immunoassay for the serodiagnostic of tuberculosis and mycobacterioses

An enzyme-linked immunosorbent assay (ELISA) test has been developed for the serodiagnosis of mycobacterioses. The test is based on an interspecific antigen, antigen 60 (A60). This antigen belongs to the group of thermostable macromolecular antigens and is the principal constituent of tuberculin RT 23. A60 is composed of proteins, polysaccharides and lipids in a ratio that varies with the growth cycle of the mycobacterium. The test detects antibodies against mycobacteria and is most effective in cases of active infections. We found that the best way to cope with the day-to-day variations in the results obtained was to transform the absorbance values into arbitrary IgG units. The variations observed with IgM antisera were, however, too great to allow more than a qualitative test. Healthy individuals are negative in the IgG and IgM tests and tuberculous patients are usually positive in the IgG test. The presence of IgM antibodies was only rarely observed. For IgG antibodies, the best discriminative power at a 1:100 dilution of the analyzed sera seemed to lie at 125 sero-units. It was found that some sera originating from clinically documented tuberculous cases responded in a poor way in this test.

Incidence of inapparent active mycobacterial infections in France detected by an IgG serological test based on antigen 60

A serological test detecting circulating mycobacterial antibodies of the IgG type applied to various populations. The test detected no positive cases among old age people in a retirement home. Among sexually active women, 3% were positive. This percentage of antigen 60-positive cases was also found among asymptomatic HIV seropositives. The percentage augmented to 5.7% when hospital attendants were analyzed and augmented further to 14% when people known to have had contact with a man suffering from pulmonary tuberculosis were analyzed.

Nocturnal asthma: slow-release terbutaline versus slow-release theophylline therapy

In a double-blind cross-over study, the effects of slow release (S-R) terbutaline tablets (b.i.d. 0.25 mg/kg per day) and S-R theophylline (5.31 mg/kg morning and 10.62 mg/kg evening) were compared in eleven patients with nocturnal asthma. On day seven of each treatment period, drug serum concentrations and peak expiratory flow (PEF) were measured every 2h over a 24-h period. During daytime, terbutaline concentrations ranged from 1.6-14.1 (median 4.5) microgram/l and during the night from 2.1-18.7 (median 4.9) micron/l. Theophylline concentrations ranged from 3.9-24.3 (median 11.5) mg/l during the day and from 3.3-20.9 (median 10.4) mg/l at night. Nocturnal wheezing occurred during theophylline treatment in four patients 7 times and during terbutaline treatment in six patients 22 times. Daytime PEF values were 472 +/- 161 l/min during theophylline therapy versus 445 +/- 169 l/min during terbutaline therapy (p less than 0.05). In the night and early morning there was no significant difference between PEF values with the two treatment forms. During theophylline treatment, fewer inhalations of beta 2-sympathomimetics were used, and there were fewer side effects. One patient experienced severe asthmatic attacks during the terbutaline treatment period. The patients preferred theophylline for the treatment of nocturnal asthma.

Nocturnal asthma: slow-release terbutaline versus slow-release theophylline therapy

In a double-blind cross-over study, the effects of slow release (S-R) terbutaline tablets (b.i.d. 0.25 mg/kg per day) and S-R theophylline (5.31 mg/kg morning and 10.62 mg/kg evening) were compared in eleven patients with nocturnal asthma. On day seven of each treatment period, drug serum concentrations and peak expiratory flow (PEF) were measured every 2h over a 24-h period. During daytime, terbutaline concentrations ranged from 1.6-14.1 (median 4.5) microgram/l and during the night from 2.1-18.7 (median 4.9) micron/l. Theophylline concentrations ranged from 3.9-24.3 (median 11.5) mg/l during the day and from 3.3-20.9 (median 10.4) mg/l at night. Nocturnal wheezing occurred during theophylline treatment in four patients 7 times and during terbutaline treatment in six patients 22 times. Daytime PEF values were 472 +/- 161 l/min during theophylline therapy versus 445 +/- 169 l/min during terbutaline therapy (p less than 0.05). In the night and early morning there was no significant difference between PEF values with the two treatment forms. During theophylline treatment, fewer inhalations of beta 2-sympathomimetics were used, and there were fewer side effects. One patient experienced severe asthmatic attacks during the terbutaline treatment period. The patients preferred theophylline for the treatment of nocturnal asthma.